A West Australian shire will terminate its contract with a long-serving general practitioner over claims the council is being held to "ransom" amid requests for up to $300,000 to fund additional locum support.
Graham Rowlands has serviced the Goldfields community of Norseman for more than a decade but is nearing retirement and sought the additional funds to reduce his workload.
The Shire of Dundas's last contract with Dr Rowlands' Norseman Medical Practice was signed in September 2017.
The agreement includes a vehicle and fully furnished house and an undertaking to "underwrite the profitability" of the practice when Dr Rowlands engages a locum during "periods of absence".
Shire president Laurene Bonza said the current subsidies equated to about $200,000 a year, but she said the council could not agree to the request for additional funds.
"If we went with that, it takes a considerable amount of our budget which means other things don't get done," she said.
"This decision doesn't have anything to do with the doctor himself ... I'm not sure of anyone who commands a $250,000 pay rise, regardless of the wonderful work they do."
She said it was a private business.
"So then the question becomes 'why don't you prop up everyone's business'," she said.
"It becomes really awkward and terrible, and it's emotive because it's the doctor."
The contract termination comes barely a month after the WA Rural Health Excellence Awards, where Dr Rowlands was presented with a long-service award for 30 years' service to rural medicine.
Cr Bonza said she hoped Dr Rowlands would continue to operate his Norseman clinic, but the termination of the current agreement meant it would no longer receive council funding.
She said small shires such as Dundas, which covered 92,886 square kilometres in an area seven times bigger than Sydney and had a population of less than 700 people, had the "least capacity to prop up someone's private business".
"We're getting a bit hammered with doctors at the moment and it's not a local government responsibility to provide medical services," she said.
"We're going to take a motion to the [Australian Local Government Association] national conference in Canberra this year to say, 'hey federal government you need to step up here and help us out here'."
The conference is due to be held from June 11-13.
"Our doctors, God bless them, they do wonderful work, but they're nearly holding us to ransom because they say you've gotta give us more money or we're not going to be here," she said.
GP sought locum support
Dr Rowlands, who has been contacted for comment, wrote to the Shire of Dundas in May last year seeking additional funding support to attract locum support.
His letter noted the shire had contributed $38,000 in the 2020-21 financial years as a locum subsidy, and that there had been no subsidy for the previous 15 years.
"In order for me to maintain the medical service in Norseman, it is imperative that I attract appropriate medical locum cover," he wrote.
"With that goal in mind, I anticipate financial support from the Dundas Shire.
"It is the industry norm for local government to support their medical practices."
Dr Rowlands noted in the letter that the Goldfields shires of Leonora and Coolgardie had contributed $758,136 and $506,415, respectively, towards health expenditure in their regions in 2020-21.
He said he had been offered locum rates of $3,000 a day in Kalgoorlie-Boulder and $3,500 for emergency department cover in New South Wales.
"I anticipate financial support of $250,000 plus related locum travel costs," he wrote.
"This will enable the provision of locum cover in a sustainable way.
"It is my intention to reduce my work commitment in transition to retirement and intend to advertise for regular locum support with a view to a job share arrangement."
Not an 'easy' decision
In a report to the council recommending it terminate the contract, Shire of Dundas chief executive Peter Fitchat said the decision was "not an easy one to make" considering the long service provided by Dr Rowlands.
"Ultimately the reason for the termination is that the shire cannot afford the request of between $250,000 to $300,000 plus all the other benefits like the free house, vehicle and fuel, and services to maintain these assets," Mr Fitchat said.
"This request will be in the region of 15 per cent of our revenue and could affect up to three full-time shire positions which will further impact other critical services the shire is providing to the community."
Mr Fitchat said Dr Rowlands' request for additional funding support triggered the legislated requirement for a formal tender process.
Advertisements seeking a Norseman medical provider ran between December last year and January this year, drawing 11 requests for documentation but only one formal submission, from Dr Rowlands.
The termination of Dr Rowlands' contract, which expires after a six-month notice period on October 31, means the hunt for a replacement is now time sensitive.
Cr Bonza said the shire was "working hard" to find a solution.
